Document Detail


Comparison of the intracoronary continuous infusion method using a microcatheter and the intravenous continuous adenosine infusion method for inducing maximal hyperemia for fractional flow reserve measurement.
MedLine Citation:
PMID:  19464416     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Inducing stable maximal coronary hyperemia is essential for measurement of fractional flow reserve (FFR). We evaluated the efficacy of the intracoronary (IC) continuous adenosine infusion method via a microcatheter for inducing maximal coronary hyperemia. METHODS: In 43 patients with 44 intermediate coronary lesions, FFR was measured consecutively by IC bolus adenosine injection (48-80 microg in left coronary artery, 36-60 microg in the right coronary artery) and a standard intravenous (IV) adenosine infusion (140 microg x min(-1) x kg(-1)). After completion of the IV infusion method, the tip of an IC microcatheter (Progreat Microcatheter System, Terumo, Japan) was positioned at the coronary ostium, and FFR was measured with increasing IC continuous adenosine infusion rates from 60 to 360 microg/min via the microcatheter. RESULTS: Fractional flow reserve decreased with increasing IC adenosine infusion rates, and no further decrease was observed after 300 microg/min. All patients were well tolerated during the procedures. Fractional flow reserves measured by IC adenosine infusion with 180, 240, 300, and 360 microg/min were significantly lower than those by IV infusion (P < .05). Intracoronary infusion at 180, 240, 300, and 360 microg/min was able to shorten the times to induction of optimal and steady-stable hyperemia compared to IV infusion (P < .05). Functional significances were changed in 5 lesions by IC infusion at 240 to 360 microg/min but not by IV infusion. CONCLUSIONS: The results of this study suggest that an IC adenosine continuous infusion method via a microcatheter is safe and effective in inducing steady-state hyperemia and more potent and quicker in inducing optimal hyperemia than the standard IV infusion method.
Authors:
Myeong-Ho Yoon; Seung-Jea Tahk; Hyoung-Mo Yang; Jin-Sun Park; Mingri Zheng; Hong-Seok Lim; Byoung-Joo Choi; So-Yeon Choi; Un-Jung Choi; Joung-Won Hwang; Soo-Jin Kang; Gyo-Seung Hwang; Joon-Han Shin
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  157     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-05-25     Completed Date:  2009-06-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1050-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, School of Medicine, Ajou University, Suwon, Korea.
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MeSH Terms
Descriptor/Qualifier:
Adenosine / administration & dosage*
Aged
Coronary Circulation* / drug effects
Coronary Vessels / drug effects
Diagnostic Techniques, Cardiovascular*
Female
Hemodynamics
Humans
Hyperemia / chemically induced*
Infusions, Intra-Arterial
Infusions, Intravenous
Male
Middle Aged
Vasodilation / drug effects
Vasodilator Agents / administration & dosage*
Chemical
Reg. No./Substance:
0/Vasodilator Agents; 58-61-7/Adenosine

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